Mental Health and Microsoft's HealthVault

I’ve written about Google Health in the past, and have been watching the development of both the Google tool and Microsoft’s HealthVault. Both have relationships with respected healthcare institutions (Google with the Cleveland Clinic and Microsoft with the Mayo Clinic), and provide tools that allow people to centralize their personal healthcare information.

For anyone interested in cost-cutting initiatives, it’s easy to scroll down the list of partnerships maintained by Google and Microsoft and get a visual representation of just how much managed care organizations are invested in growing their share of our healthcare dollars. CVS/Caremark is everywhere.

Microsoft seems to have wandered much farther into the healthcare abyss, building what almost feels like a virtual healthcare mall. They’ve added interface ability with devices as well as a number of self-assessments designed to help users determine whether a potential healthcare problem exists, such as swine flu and mood/anxiety disorders.

These self assessments caught my attention, and because I have an educational background in clinical psychology, I decided to try My Mood Monitor, which takes approximately 3 minutes to complete, but is purported to provide a single rating of general mental health.

Wow, 3 minutes, really? So, I took the assessment and because I’m a generally happy person, it wasn’t a huge surprise that the results showed no problems with depression, anxiety, PTSD, or bipolar disorder.

What was a little disconcerting, though, were the several paragraphs that let me know that I could still be suffering from one of these disorders. Not a sentence reconfirming that this is not a diagnostic tool, but a detailed explanation of how I could still be in poor mental health.

On a lark, I decided to go through the questionnaire again and systematically mark one of the three “middle of the road” ratings for each prompt, avoiding the most extreme responses. My results showed that I had an almost 70% chance of being depressed, and a 90% chance of having an anxiety disorder. On the third try, I randomly chose one of the three “middle of the road” ratings for each prompt, and received a warning about all four disorders.

With all due respect to Microsoft, I suspect that this type of self-assessment does little more than possibly encourage people to talk to their doctors more about their mental state, regardless of what that mental state is. And while I understand that this can help some people, I’m not sure it is beneficial overall, due to the following:

1. Primary care physicians (including pediatricians) are already supposed to screen patients for mental health issues as a part of routine office visits;
2. Many of the issues presented in the questionnaire are easily identified through public education;
3. Our challenges may lie less in identifying poor mental health than in treating it;
4. The American public in general may be becoming hypersensitive to their own physical and mental states.

The last point in particular comes from personal observation. As a society, we are bombarded with information regarding the medications that will solve our sleep problems, enhance our sex lives, help us lose weight, and keep us from getting pregnant while treating our acne at the same time.

When I look at the state of our healthcare system, I have to wonder how many of these treatments really are medically necessary. If a woman is not as concerned about sex at age 50 as she was at age 30, is there necessarily something mentally or physically wrong? But perhaps more importantly, at what point did we begin to medically treat people so that they can maintain unhealthy lifestyles?

I couldn’t find online information about M3 Information, the company that created My Mood Monitor online, outside of the brief information included in the tool that told me that at least two of the four people associated with the company likely have interests in the pharmaceutical industry. I could tie all of this back to the HealthVault virtual “mall,” but I’ll put it to rest here.

Suffice to say that I don’t think a 3-minute online self assessment is a practical tool for enhancing the ability of physicians to detect mental illness in patients. What are your thoughts?